___________ How many drivers reside in your household?
Y____ N____ Are any of your vehicles financed or leased?
Y____ N____ Are any household members furnished a company vehicle?
Y____ N____ Do any household members travel or occasionally rent vehicles?
Y____ N____ Does anyone in your household drive vehicles not listed on your policy?
Y____ N____ Are any of your vehicles equipped with audio equipment that is not permanently installed?
Y____ N____ Do you currently have roadside assistance service for your vehicles?
Y____ N____ Do any household members travel outside of the United States?
Y____ N____ Do any household members own an antique car, motorcycle or recreational vehicle?